Healthcare Provider Details

I. General information

NPI: 1366223109
Provider Name (Legal Business Name): CAMERON JO HEATON CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAMI HEATON CSW

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 W 920 N
OREM UT
84057-3044
US

IV. Provider business mailing address

462 W 920 N
OREM UT
84057-3044
US

V. Phone/Fax

Practice location:
  • Phone: 801-372-8340
  • Fax:
Mailing address:
  • Phone: 801-372-8340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13111712-3502
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: